Hypothyroidism

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Hypothyroidism Main page
Patient Information
Overview
Classification Primary hypothyroidism Hashimoto's thyroiditis Secondary hypothyroidism Tertiary hypothyroidism
Differentiating different causes of hypothyroidism
Screening
Diagnosis
History and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

Synonyms and keywords: Myxedema; myxoedema; thyroid activity decreased; hypothyroid

General feature

Symptoms

cold intolerance

puffiness

decreased sweating

coarse skin

obstructive sleep apnea (secondary to macroglossia)

carpal tunnel syndrome

Females can present with galactorrhea and menstrual disturbances

• Fever if accompanied by thyroiditis
• fatigue
• loss of energy
• lethargy
• weight gain
• decreased appetite
• cold intolerance
• dry skin
• hair loss
• sleepiness
• muscle pain
• joint pain
• weakness in the extremities
• depression
• emotional lability
• mental impairment
• forgetfulness
• impaired memory
• inability to concentrate
• constipation
• impaired fertility
• decreased perspiration
• paresthesia and nerve entrapment syndromes
• blurred vision
• decreased hearing
• fullness in the throat
• hoarseness
• neck pain
• sore throat

Signs

hypothermia; weight gain; slowed speech and movements; dry skin; jaundice; pallor; coarse, brittle, straw like hair; loss of scalp hair, axillary hair, pubic hair, or a combination; dull facial expression; coarse facial features; periorbital puffiness; macroglossia; goiter; hoarseness; decreased systolic blood pressure and increased diastolic blood pressure; bradycardia; pericardial effusion; abdominal distension, ascites (uncommon); non-pitting edema (myxedema); pitting edema of lower extremities; hyporeflexia with delayed relaxation, ataxia, or both

• Metabolic abnormalities associated with hypothyroidism include:
  • anemia,
  • dilutional hyponatremia,
  • hyperlipidemia,
  • reversible increase in creatinine

Complications

Myxedema coma

Rare, severe form of hypothyroidism, a life-threatening condition

• Altered mental status,
• hypothermia,
• bradycardia,
• hypercarbia, and
• hyponatremia.
• Cardiomegaly,
• pericardial effusion,
• cardiogenic shock, and
• ascites
• commonly occurs in individuals with undiagnosed or untreated hypothyroidism who is subjected to an external stress, such as low temperature, infection, or medical intervention (e.g., surgery or hypnotic drugs)